Individual
MRS. MARY JANE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CHES
Contact information
Practice address
1450 N COUNTY ROAD 2050 E, CARTHAGE, IL 62321-3551
(217) 357-6832
(217) 357-6839
Mailing address
PO BOX 160, CARTHAGE, IL 62321-0160
(217) 357-6832
(217) 357-6839
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
9468
PA
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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